PHOENIX HOUSES OF LOS ANGELES, INC. (NPI# 1497809735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497809735 |
| Entity Type | Organization |
| Organization Name | PHOENIX HOUSES OF LOS ANGELES, INC. |
| Practice Address |
503 Ocean Front Walk Venice CA 90291-2403 |
| Practice Telephone | 3103923070 |
| Practice Fax Number | 3103929068 |
| Mailing Telephone | 3103923070 |
| Mailing Fax Number | 3103929068 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2013-11-26 |
| Authorized Official Name | MR. POURIA ABBASSI (SR. VICE PRESIDENT, REGIONAL DIRECT) |
| Authorized Official Telephone | 8186863000 |
| Authorized Official Credential | P.E. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 190115AN | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235283722 | Phoenix Houses of Los Angeles, Inc. | Substance Abuse Rehabilitation Facility | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2007-01-22 |
| 1427594639 | Phoenix Houses of Los Angeles, Inc. | Substance Abuse Rehabilitation Facility | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2017-01-11 |
| 1437205408 | Phoenix Houses of Los Angeles, Inc. | Substance Abuse Rehabilitation Facility | 11015 Bloomfield Ave, Santa Fe Springs, CA 90670-4601 | 2007-01-25 |
| Street Address |
503 OCEAN FRONT WALK |
| City | VENICE |
| State | CA |
| Zip Code | 90291-2403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689273518 | Lauren Mazahery | Social Worker | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2020-10-21 |
| 1366066961 | Juan Francisco Hernandez | Social Worker | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2020-05-31 |
| 1164045886 | Vincent Giovanni Cruz | Counselor | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2020-05-28 |
| 1598388563 | Rolando Soria Bonita | Licensed Vocational Nurse | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2020-05-25 |
| 1699397125 | Gerardo Rojas | Counselor | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2020-05-06 |
| 1982225512 | Cheronna Shaunte' Moron | Licensed Vocational Nurse | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2020-05-05 |
| 1750926408 | Michel Ferguson | Counselor | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2019-11-15 |
| 1881239739 | Barron Lesean Carter | Counselor | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2019-11-14 |
| 1457992000 | Laura Sofia Hernandez | Case Manager/Care Coordinator | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2019-10-04 |
| 1457901589 | Daniel John Bouchard | Counselor | 503 Ocean Front Walk, Venice, CA 90291-2403 | 2019-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033629837 | Dylan Booth | Dentist | 601 Vernon Ave, Venice, CA 90291 | 2017-10-05 |
| 1467979500 | Linda Sittler | Registered Nurse | 1025 Palms Ave, Venice, CA 90291 | 2017-08-29 |
| 1003218660 | Patricia Guadalupe Rivas | Counselor | 717 Lincoln Blvd., Venice, CA 90291 | 2014-09-25 |
| 1497016877 | Carrie Lynn Kowalski | Physician Assistant | 604 Rose Avenue, Venice, CA 90291 | 2012-06-02 |
| 1821364761 | Cheryl Lynn Perkins | Nutritionist | 215 Culver Boulevard, # 5203, Playa Del Rey, CA 90291 | 2012-03-26 |
| 1629391875 | James L. Hoff | Optometrist | 1636 Abbot Kinney Blvd., Venice, CA 90291 | 2010-03-02 |
| 1720315096 | Kristen Nicol Leishman | Counselor | 911 Coeur D'alene Ave, Venice, CA 90291 | 2009-11-06 |
| 1922237882 | David Anthony Garcia | Physician Assistant | 15031 Rinaldi St., Providence Holy Cross Medical Center Ed, Mission Hills, CA 90291 | 2009-07-13 |
| 1548411010 | David Watts | Acupuncturist | 307 S. Robertson Blvd, Beverly Hills, CA 90291 | 2008-10-02 |
| 1184891699 | Judy Alexander | Voluntary or Charitable | 204 Hampton Drive, St Joseph Center, Venice, CA 90291 | 2008-05-14 |
| Find all providers in zip 90291 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610060 | 2435 Glyndon LLC | Substance Abuse Rehabilitation Facility | 2435 Glyndon Ave, Venice, CA 90291-5004 | 2019-03-27 |
| 1356726913 | Passages Malibu Php, LLC | Substance Abuse Rehabilitation Facility | 1728 Abbot Kinney Blvd, #103, Venice, CA 90291-4839 | 2015-07-24 |
| 1427214261 | Clearview Centers LLC | Substance Abuse Rehabilitation Facility | 2432 Walnut Ave, Venice, CA 90291-5019 | 2008-07-31 |
| 1831518216 | 2432 Walnut LLC | Substance Abuse Rehabilitation Facility | 2432 Walnut Ave, Venice, CA 90291-5019 | 2014-04-14 |
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| 1871191569 | Old Oak Ranch Recovery Center | Substance Abuse Rehabilitation Facility | 19401 Susan Way, Sonora, CA 95370-9266 | 2020-10-14 |
| 1962009845 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 9952 Grandview Dr, La Mesa, CA 91941-6874 | 2020-10-05 |
| 1376140384 | Magic House Recovery Inc | Substance Abuse Rehabilitation Facility | 1001 S Mountvale Ct, Anaheim, CA 92808-2108 | 2020-10-02 |
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.